Awesome Dexamethasone High

My friend was on a steroid as treatment for something his body was fighting, maybe before a medical procedure of some kind. Early in the morning his wife woke up in an empty bed. Looking out the window she saw him up on a ladder, tirelessly scraping at the wall. They reported that before breakfast that day he did the work of five men.

I read this account just now, from a guy who took dexamethasone in the lead up to surgery for an acoustic neuroma:

I can’t imagine that anyone took me seriously during those weeks of higher-than-hell discombobulation — and if they did, they shouldn’t have. After all, I was a sick man on the brink of a life-changing operation, feeling a false sense of invincibility thanks to a flush of steroids. So I get where Trump is coming from, and I can somewhat understand the misguided, Chuck Norris-worthy level of bravado that comes with dramatically walking up a set of steps, defiantly tearing off your mask, and saluting a military helicopter as it flies into the sunset. He probably feels like the hero in his own action movie right now, and maybe he deems it necessary to communicate that sense of strength to the rest of the world.

The problem is, it’s not real strength. It’s a steroid. It’s a drug. And, judging by my personal experience, dexamethasone may be giving him the same false feeling of stability and empowerment that it gave me.

The difference? I was a touring musician singing songs about my wife; Trump is the leader of the free world with literally millions of lives in his hands.

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Dexamethasone is a cheap and widely available corticosteroid that is used to head off an immune system overreaction and treat inflammation. 

The drug has risen to prominence as a COVID-19 treatment after a study published in the New England Journal of Medicine in July found it significantly improved the chances of survival for seriously ill COVID-19 patients.

Researchers behind the study found the drug reduced deaths by 35 percent for patients on ventilators and by 20 percent in those only needing supplemental oxygen, although the steroid did not appear to show any benefit to COVID-19 patients who didn’t require ventilation or oxygen.

The announcement that Trump was being treated with dexamethasone raised concerns about the severity of his condition as the drug is typically reserved for patients with severe COVID-19 and not prescribed to patients in the early stages of infection as it can suppress the immune system’s capability to fight off the virus. 

The National Institutes of Health’s treatment guidelines recommend against the use of dexamethasone for the treatment of patients who do not require supplemental oxygen. 

Trump’s doctors said the president received oxygen on Friday following a temporary drop in oxygen level. On Saturday morning, Trump’s oxygen saturation dropped to 93 percent, prompting the decision to initiate the steroid therapy. Healthy blood oxygen levels range from 95 to 100 percent. 

Dexamethasone can cause a range of side effects, from blood clots, headaches and blurred vision to aggression, agitation, anxiety, irritability and depression. 

“It can cause psychosis. It can cause delirium. It can cause mania,” Megan Ranney, an emergency physician and associate professor at Brown University, told CNN Sunday.

“I would never want to say the president is experiencing steroid-induced psychosis, but it is certainly concerning to see some of his actions today in the wake of this potentially deadly diagnosis and infectious disease.” 

Peter Bach, director of the Center for Health Policy and Outcomes at Memorial Sloan Kettering Cancer Center, told The Washington Post a well-known effect of the drug is euphoria and the tendency to over-exaggerate how well they feel. 

Dexamethasone is also a banned performance-enhancing drug, according to the World Anti-Doping Agency’s 2019 list of prohibited drugs. The drug is listed under “glucocorticoids,” which are prohibited when administered by oral, intravenous, intramuscular or rectal routes. 

Prior to the recent presidential debate, Trump demanded former Vice President Joe Biden take a drug test, suggesting Biden had used drugs to bolster his performance during the Democratic debates. 

“I will be strongly demanding a Drug Test of Sleepy Joe Biden prior to, or after, the Debate on Tuesday night. Naturally, I will agree to take one also,” Trump tweeted. “His Debate performances have been record setting UNEVEN, to put it mildly. Only drugs could have caused this discrepancy???” 

Trump tweeted Tuesday he plans to move forward with the second presidential debate scheduled for Oct. 15 in Miami.  

Trump, who is still infected with the virus, was discharged from Walter Reed Monday evening and returned to the White House determined to show the public he had gotten the better of the virus. He walked up the stairs of the South Portico upon his return, removed his mask and posed for photos while looking over the balcony above the South Lawn. 

In a video posted to Twitter following his return, Trump said he “felt better than 20 years ago” and urged people not to be afraid of the coronavirus or let it “dominate” their lives. 

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